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03-01-2024 | Cytostatic Therapy | Thoracic Oncology

Long-Term Survival and Recurrence Patterns in Locally Advanced Esophageal Squamous Cell Carcinoma Patients with Pathologic Complete Response After Neoadjuvant Chemotherapy Followed by Surgery

Authors: Ya-Ya Wu, MD, Liang Dai, MD, Yong-Bo Yang, MD, Wan-Pu Yan, MD, Hong Cheng, MD, Meng-Ying Fan, MD, Yi-Mei Gao, MD, Ke-Neng Chen, MD

Published in: Annals of Surgical Oncology | Issue 8/2024

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Abstract

Background

The higher pathologic complete response (pCR) after neoadjuvant chemoradiotherapy compared with neoadjuvant chemotherapy for locally advanced esophageal squamous cell carcinoma (ESCC) has not translated into significant gains in overall survival. Data on the long-term survival of patients who obtained a pCR after neoadjuvant chemotherapy are scarce. Therefore, this study aimed to evaluate the long-term prognosis and recurrence patterns in these patients.

Methods

The study enrolled patients with locally advanced ESCC after neoadjuvant chemotherapy followed by surgery in the authors’ hospital between January 2007 and December 2020. The factors predictive of pCR were analyzed. Furthermore, propensity score-matching was performed for those who did and those who did not have a pCR using 1:5 ratio for a long-term survival analysis. Finally, the survival and recurrence patterns of patients obtaining pCR after neoadjuvant chemotherapy were analyzed.

Results

A pCR was achieved for 61 (8.70%) of the 701 patients in the study. Univariate analysis showed that the patients without alcohol drinking had a higher possibility of obtaining a pCR, although multivariate analysis failed to confirm the difference as significant. After propensity score-matching, the 5-year overall survival was 84.50% for the patients who had a pCR and 52.90% for those who did not (p < 0.001). Among the 61 patients with a pCR, 9 patients (14.80%) experienced recurrence, including 6 patients with locoregional recurrence and 3 patients with distant metastasis.

Conclusion

Advanced ESCC patients with pCR after neoadjuvant chemotherapy had a favorable prognosis, yet some still experienced recurrence, particularly locoregional recurrence. Therefore, for this group of patients, regular follow-up evaluation also is needed.
Literature
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go back to reference NCCN Clinical Practice Guidelines in Oncology (NCCN guidelines). Esophageal and Esophagogastric Junction Cancers. Version 3.2022. National Comprehensive Cancer Network, Fort Washington, 2022. NCCN Clinical Practice Guidelines in Oncology (NCCN guidelines). Esophageal and Esophagogastric Junction Cancers. Version 3.2022. National Comprehensive Cancer Network, Fort Washington, 2022.
14.
Metadata
Title
Long-Term Survival and Recurrence Patterns in Locally Advanced Esophageal Squamous Cell Carcinoma Patients with Pathologic Complete Response After Neoadjuvant Chemotherapy Followed by Surgery
Authors
Ya-Ya Wu, MD
Liang Dai, MD
Yong-Bo Yang, MD
Wan-Pu Yan, MD
Hong Cheng, MD
Meng-Ying Fan, MD
Yi-Mei Gao, MD
Ke-Neng Chen, MD
Publication date
03-01-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14809-1
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